title: Levels of the epidermal growth factor-like peptide amphiregulin in follicular fluid reflect the mode of triggering ovulation: a comparison between gonadotrophin-releasing hormone agonist and urinary human chorionic gonadotrophin.
abstract: OBJECTIVE
  To detect differences in follicular fluid (FF) levels of amphiregulin (AR), depending on mode of triggering final oocyte maturation.
  
  
  METHODS
  Prospective randomized trial.
  
  
  METHODS
  Three IVF units.
  
  
  METHODS
  Ninety-six patients undergoing IVF-intracytoplasmic sperm injection.
  
  
  METHODS
  Ovulation triggered with either urinary hCG or GnRH agonist (GnRH-a).
  
  
  METHODS
  15 FF samples from small antral follicles (3-9 mm) and 12 FF samples from natural cycle.
  
  
  METHODS
  Follicular fluid concentration of AR, P4, E2, vascular endothelial growth factor, and inhibin B.
  
  
  RESULTS
  Significantly lower levels of AR were found in FF from the GnRH-a group versus the hCG group, 51±3.5 versus 71±6.0 ng/mL. In FF from natural cycles, levels of AR were significantly higher than those of GnRH-a triggering but significantly lower than those of urinary hCG triggering. In small antral follicles only 5 out of 15 follicles contained measurable amounts of AR. When urinary hCG and GnRH-a triggering were compared, FF P4 was significantly higher after urinary hCG triggering, whereas no difference was seen regarding E2, vascular endothelial growth factor, and inhibin B. A total of 14% more metaphase II oocytes and 11% more transferable embryos were obtained after GnRH-a triggering.
  
  
  CONCLUSIONS
  This study suggests that oocyte competence is linked to granulosa cell AR secretion.
authors.affiliation: Fertility Clinic, Skive Regional Hospital, Skive, Denmark. peter.humaidan@viborg.rm.dk
authors.forename: Peter
authors.initials: P
authors.lastname: Humaidan
authors.forename: Lars Grabow
authors.initials: LG
authors.lastname: Westergaard
authors.forename: Anne Lis
authors.initials: AL
authors.lastname: Mikkelsen
authors.forename: Misao
authors.initials: M
authors.lastname: Fukuda
authors.forename: Claus
authors.initials: C
authors.lastname: Yding Andersen
mesh_terms: D000328:Adult; D066258:Amphiregulin; D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D066255:EGF Family of Proteins; D004815:Epidermal Growth Factor / Q000737:chemistry / Q000378:metabolism; D005260:Female; D005307:Fertilization in Vitro; D015571:Follicular Fluid / Q000737:chemistry / Q000378:metabolism*; D006023:Glycoproteins / Q000032:analysis / Q000378:metabolism*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000032:analysis / Q000378:metabolism*; D008596:Menotropins / Q000627:therapeutic use; D010062:Ovulation Induction / Q000379:methods*; D010455:Peptides / Q000737:chemistry / Q000378:metabolism; D011247:Pregnancy; D018873:Pregnancy Rate; D017329:Triptorelin Pamoate / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: C587848:AREG protein, human; D066258:Amphiregulin; D006063:Chorionic Gonadotropin; D066255:EGF Family of Proteins; D006023:Glycoproteins; D036341:Intercellular Signaling Peptides and Proteins; D010455:Peptides; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins; D004815:Epidermal Growth Factor; C066438:deslorelin